The Italian Society of Cardiology and Working Group on Telecardiology and Informatics 2023 updated position paper on telemedicine and artificial intelligence in cardiovascular disease

Brunetti, Natale Daniele; Curcio, Antonio; Nodari, Savina; Parati, Gianfranco; Carugo, Stefano; Molinari, Martina; Acquistapace, Flavio; Gensini, Gianfranco; Molinari, Giulia

doi:10.2459/jcm.0000000000001447

Cited by 8 publications

(2 citation statements)

References 90 publications

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“…Considering previously described clinical benefits (including early diagnosis and targeted treatment) of remote monitoring, 9 patients were followed using an automatic remote monitoring system allowing the transmission of up to six sECG daily recordings of detected arrhythmias. The remote data were accessible to hospital staff through a secure website.…”

Section: Implantable Cardiac Monitors and Follow-upmentioning

confidence: 99%

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

Maines,

Rotondi,

Guarracini

et al. 2024

Journal of Cardiovascular Medicine

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Aims In this study, we investigated a cohort of unselected patients with various indications for an implantable cardiac monitor (ICM). Our main objectives were to determine the incidence of arrhythmic diagnoses, both anticipated and incidental in relation to the ICM indication, and to assess their clinical relevance. Methods We examined remote monitoring transmissions from patients with an ICM at four Italian sites to identify occurrences of cardiac arrhythmias. Concurrently, we collected data on medical actions taken in response to arrhythmic findings. Results The study included 119 patients, with a median follow-up period of 371 days. ICM indications were syncope/presyncope (46.2%), atrial fibrillation management (31.1%), and cryptogenic stroke (22.7%). In the atrial fibrillation management group, atrial fibrillation was the most common finding, with an incidence of 36% [95% confidence interval (CI) 22–55%] at 18 months. Rates of atrial fibrillation were not significantly different between patients with cryptogenic stroke and syncope/presyncope [17% (95% CI 7–40%) vs. 8% (95% CI 3–19%), P = 0.229]. For patients with cryptogenic stroke, the incidence of asystole and bradyarrhythmias at 18 months was 23% (95% CI 11–45%) and 42% (95% CI 24–65%), respectively, similar to estimates obtained for patients implanted for syncope/presyncope (P = 0.277 vs. P = 0.836). Overall, 30 patients (25.2%) required medical intervention following ICM-detected arrhythmias, predominantly involving atrial fibrillation ablation (10.9%) and medication therapy changes (10.1%). Conclusion In a real-life population with heterogeneous insertion indications, approximately 25% of patients received ICM-guided medical interventions within a short timeframe, including treatments for incidental findings. Common incidental arrhythmic diagnoses were bradyarrhythmias in patients with cryptogenic stroke and atrial fibrillation in patients with unexplained syncope.

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Section: Implantable Cardiac Monitors and Follow-upmentioning

confidence: 99%

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

Maines,

Rotondi,

Guarracini

et al. 2024

Journal of Cardiovascular Medicine

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“…During the COVID-19 epidemic, this technology has been used successfully to give medical advice, alter medication, and monitor ambulatory HF patients. [ 78 , 79 ]…”

Section: Impact Of Covid-19 Pandemic On Treatment Delay and Icd Impla...mentioning

confidence: 99%

Revascularization and Left Ventricular Dysfunction for ICD Eligibility

Romano,

Spaccarotella,

Indolfi

et al. 2023

Life

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Common triggers for sudden cardiac death (SCD) are transient ischemia, hemodynamic fluctuations, neurocardiovascular influences, and environmental factors. SCD occurs rapidly when sinus rhythm degenerates into ventricular tachycardia (VT) and/or ventricular fibrillation (VF), followed by asystole. Such progressive worsening of the cardiac rhythm is in most cases observed in the setting of ischemic heart disease and often associated with advanced left ventricular (LV) impairment. Revascularization prevents negative outcomes including SCD and heart failure (HF) due to LV dysfunction (LVD). The implantable cardioverter–defibrillator (ICD) on top of medical therapy is superior to antiarrhythmic drugs for patients with LVD and VT/VF. The beneficial effects of ICD have been demonstrated in primary prevention of SCD as well. However, yet debated is the temporal management for patients with LVD who are eligible to ICD prior to revascularization, either through percutaneous or surgical approach. Restoration of coronary blood flow has a dramatic impact on adverse LV remodeling, while it requires aggressive long-term antiplatelet therapy, which might increase complication for eventual ICD procedure when percutaneous strategy is pursued; on the other hand, when LV and/or multiorgan dysfunction is present and coronary artery bypass grafting is chosen, the overall risk is augmented, mostly in HF patients. The aims of this review are to describe the pathophysiologic benefits of revascularization, the studies addressing percutaneous, surgical or no revascularization and ICD implantation, as well as emerging defibrillation strategies for patients deemed at transient risk of SCD and/or at higher risk for transvenous ICD implantation.

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Smart Technologies used as Smart Tools in the Management of Cardiovascular Disease and their Future Perspective

Ullah

Hamayun

Wahab

et al. 2023

Current Problems in Cardiology

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The Italian Society of Cardiology and Working Group on Telecardiology and Informatics 2023 updated position paper on telemedicine and artificial intelligence in cardiovascular disease

Cited by 8 publications

References 90 publications

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

Revascularization and Left Ventricular Dysfunction for ICD Eligibility

Smart Technologies used as Smart Tools in the Management of Cardiovascular Disease and their Future Perspective

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